What causes newborn’s skin to turn yellow after birth?
The yellowing of skin (and white of eyes) in newborn is known as neonatal jaundice. It occurs commonly in the first week of life due to the accumulation of bilirubin in the skin and mucous membranes. Approximately 65% of newborns will develop the condition which is caused by raised bilirubin (higher than 6 mg/dL) in the blood circulation.
Bilirubin is formed from the breaking down of the red blood cells. It is an important antioxidant that protects newborns from oxygen toxicity in the first days of life due to their general deficient in antioxidants such as catalase, superoxide dismutase and vitamin E.
It is normally processed in the liver before being passed out to the gut as part of bile juice. It is then metabolized by the micro-organism living in the gut before being excreted in stools. Slower rate of excretion in newborns is caused by the absence of gut flora as well as the slow bowel movement which in turn promote bilirubin reabsorption in the gastrointestinal tract. Accumulation of high levels of bilirubin in the body can lead to jaundice.
What are the risk factors for neonatal jaundice?
Is neonatal jaundice harmful?
Under normal circumstances, bilirubin levels will peak at around day 3 – 5 after birth with a total bilirubin level of not more than 15 mg/dL. In most cases, neonatal jaundice is not harmful where visible yellowing of the skin generally resolves by week-1 in a full term newborn and by week-2 in a preterm newborn.
Nevertheless, 8 to 10% of newborns may experience excessively high concentrations of bilirubin in blood, with levels exceeding 17 mg/dL whereas 1 to 2% may have levels above 20 mg/dL.
Bilirubin in its unconjugated anionic form is toxic to the nerve cells hence excessive accumulation in the central nervous system (brain and spinal cord) can cause bilirubin encephalopathy which is associated with brain damage and hearing loss.
Signs and symptoms of bilirubin encephalopathy
Newborns with bilirubin encephalopathy may show the following symptoms, although some of these are non-specific signs that can be indicative of other conditions:
What should I do if I think my child is suffering from neonatal jaundice with or without bilirubin encephalopathy?
Seek immediate medical attention. A blood test will be carried out to determine newborn’s blood bilirubin level. Excessive levels of bilirubin in the blood may require:
You should not try to treat the neonatal jaundice at home using:
Download our Doc2Us app from Google Play Store or Apple Store and chat with a doctor now.
In collaboration with Dosing Health
Introducing Doc2Us, your personal pocket doctor at your fingertips. With its name synonymous to “talk to us”, Doc2Us is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere.